+ first contact +
rachel contacted me via email this evening, and already i have propelled myself into this project without having experienced it for more than the ten minutes it took me to digest her proposal.
the problem
obstetric fistulas are common with poor women born in rural areas without proper obstetric care. they are usually forced into an early marriage, and a combination of early pregnancy and malnourishment causes the bodies of these women to be underdeveloped for birth. their labors become obstructed for up to days at a time with no assistance other than that of a traditional midwife. the baby's head it forced against the pelvic walls and it is consistently being pushed by contractions. the soft tissue between the baby's head and the pelvis eventually dies (necrosis), and a hole (fistula) occurs.
the baby is typically birthed stillborn, and the woman leaks urine and/or feces due to the fistula. she is abandoned by her family, because she is seen as worthless by her husband and he often divorces and remarries another woman. her smell and leakage forces her out of her community. she has no means of income and suffers greatly both physically and emotionally from the loss of her baby and her family.
what i find most unsettling is that fistula is not only preventable (by c-sections and family planning), but curable. however, most women either are not aware of this or do not have the financial means to get surgery. travel is a large issue because of a lack of decent roadways as well as long distances. not only that, but if a women actually has the money and the ability to travel, most medical facilities do not accommodate fistula repair.
the solution
create a medical center that focuses on the hollistic process of birth with an emphasis on fistula repair. proper education on what a fistula is, what causes it, and how to prevent are the beginning steps to corrected this epidemic. this includes family planning and birth control. the facilities to repair fistula will help to reverse the problem, and proper birth supervision from a trained staff will ensure safe labor. physical and psychological therapy plays a major role in recovery. women can relate to and empower each other. vocational skills will be taught to those in need in order to have successful community reintegration.
this is not an imposition of western medical practice on traditional eastern culture. the birthing process at this center is to remain natural in the eyes of the culture, but with the capability of medical assistance for any complications.